Sleep apnea usually is a chronic (ongoing) condition that disrupts sleep. Apnea literally means absence of breathing during sleep. When apneas occur, the body wakes up, at least partially, in order to be able to breathe, although most people do not remember this and as a result there is movement out of deep sleep and into light sleep when breathing pauses or becomes shallow. This frequent partial or complete waking up causes poor quality sleep, which leads to excessive daytime sleepiness. As a result, daytime performance suffers. Often, one is less energetic and much more apt to fall asleep in inappropriate settings, such as at work, while driving, taking classes, sitting in meetings and more.

To accurately diagnose sleep apnea, a person must spend at least one night in a sleep lab. Here, various monitors are placed on the patient, such as EEG, EKG, EMG, pulse oximeter, thermocoupler(s)and respiratory effort straps. All these tests are non-invasive and painless (except during the scrubbing/prepping process). A few sleep labs may even insert a special balloon into the throat. However, this is rarely used due to its significant discomfort. In addition, a video camera will be focused on the patient to check for strange behaviors while asleep. During the night, the patient is observed and monitored from a nearby room. Everything is recorded for later review by a doctor. Sometimes, sleep apnea can be intermittent and this can require more than one night in a sleep lab.

In addition to one or more overnight sleep studies, a person may also undergo a multiple sleep latency test (MSLT). Here, a patient is wired up the same way as for an overnight sleep study, but connected to one or more cables that can be easily connected and disconnected. The person is free to do whatever he or she wants between scheduled nap periods. At regular intervals (usually 2 hours), the person will be connected to the monitoring equipment and be given an opportunity to take a short snooze. If the patient does not fall asleep within an allotted time (usually between 20-35 minutes), he or she is said to be doing satisfactory at that point in the test. The test usually covers the course of a standard workday.

Sleep apnea often goes undiagnosed. Providers usually can't detect the condition during routine office visits. Also, there are no blood tests for the condition. Most people who have sleep apnea don't know they have it because it only occurs during sleep. A family member and/or bed partner may first notice the signs of sleep apnea.

Untreated sleep apnea can:

• Increase the risk for high blood pressure, heart attack, stroke, obesity and diabetes
• Increase the risk for or worsen heart failure
• Make irregular heartbeats more likely
• Increase the chance of having work-related or driving accidents
• Create poor daytime performance at work or school
• Affect mood, memory and cognition

Lifestyle changes, mouthpieces, surgery and/or breathing devices can successfully treat sleep apnea in many people.

When you're awake, throat muscles help keep your airway stiff and open so air can flow into your lungs. When you sleep, these muscles are more relaxed. Normally, the relaxed throat muscles don't stop your airway from staying open to allow air into your lungs.
But if you have obstructive sleep apnea, your airways can be blocked or narrowed during sleep because:

• Your throat muscles and tongue relax more than normal.
• Your tongue and tonsils (tissue masses in the back of your mouth) are large compared to the opening into your windpipe.
• You're overweight. The extra soft fat tissue can thicken the wall of the windpipe. This causes the inside opening to narrow and makes it harder to keep open.
• The shape of your head and neck (bony structure) may cause a smaller airway size in the mouth and throat area.
• The aging process limits the ability of brain signals to keep your throat muscles stiff during sleep. This makes it more likely that the airway will narrow or collapse.

Not enough air flows into your lungs when your airways are fully or partly blocked during sleep. This can cause loud snoring and a drop in your blood oxygen levels.
When the oxygen drops to dangerous levels, it triggers your brain to disturb your sleep. This helps tighten the upper airway muscles and open your windpipe. Normal breaths then start again, often with a loud snort or choking sound.
The frequent drops in oxygen levels and reduced sleep quality trigger the release of stress hormones. These compounds raise your heart rate and increase your risk for high blood pressure, heart attack, stroke and irregular heartbeats. The hormones also raise the risk for or worsen heart failure.
Untreated sleep apnea also can lead to changes in how your body uses energy. These changes increase your risk for obesity and diabetes.

What Are the Signs and Symptoms of Sleep Apnea?

• Morning headaches
• Daytime sleepiness
• Lack of energy
• Excessive daytime sleepiness
• Falling asleep at inappropriate times (i.e. driving)
• Depression
• Lack of interest in things
• Frequent, but brief awakenings during the night
• Gasping for breath during sleep
• Making strange noises during sleep
• New irregular hear rhythms
• New high blood pressure of difficult to control high blood pressure
• Newly diabetic or difficulty controlling blood sugars
• Congestive heart failure possibly with shortness of breath and/or swelling in the extremities
• Memory or learning problems and difficulty with concentration
• Feeling irritable, mood swings, personality changes
• Frequent nighttime urination
• A dry throat upon awakening

The goals of treating obstructive sleep apnea are to:

• Restore regular breathing during sleep
• Relieve symptoms such as loud snoring and daytime sleepiness

Treatment may help other medical problems linked to sleep apnea, such as high blood pressure. Treatment also can reduce your risk for heart disease, stroke and diabetes.

• Avoid alcohol and medicines that make you sleepy. They make it harder for your throat to stay open while you sleep.
• Lose weight if you're overweight or obese. Even a little weight loss can improve your symptoms.
• Sleep on your side instead of your back to help keep your throat open. You can sleep with special pillows or shirts that prevent you from sleeping on your back.
• Keep your nasal passages open at night with nose sprays or allergy medicines, if needed. Talk to your provider about whether these treatments might help you.
• Stop smoking.